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Section Questions and Answers

Dry Mouth Or Xerostomia

  1. What is xerostomia?
  2. What are the causes of xerostomia?
  3. What are the effects of dry mouth?
  4. What treatment is there for dry mouth?
  5. Where does saliva come from?
  6. What are the functions of saliva?
  7. How does saliva prevent tooth decay and gum disease?
  8. What influences the flow of saliva?

 
1. What is xerostomia?

  • This is a persistently dry mouth caused by a reduced production of saliva.
  • It is not the ordinary dry mouth that can be cured by drinking a glass of water.

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2. What are the causes of xerostomia?

  • Inadequate chewing is a common cause of dry mouth.
    • Chewing is needed to stimulate the flow of saliva.
      The frail and elderly can have difficulty chewing.
      If food is not chewed properly a dry mouth can develop.
    • Older people may avoid eating food that needs to be chewed well.
      This may be because of ill-fitting dentures, or because of frailty or ill health.
  • Most older people are on medication, and some medications and other therapies can cause dry mouth. They are:
    • Medication such as anti-histamines, anti-depressants and drugs to reduce blood pressure.
    • Radiotherapy.
  • Other causes can be:
    • HIV and AIDS.
    • Mouth breathing.
    • Fatigue and anxiety.
  • Ageing does not cause dry mouth. It is present in the elderly only when it is a symptom of a problem.

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3. What are the effects of dry mouth?

  • Dry mouth causes a great deal of discomfort and can cause the following:
    • The mouth becomes more susceptible to tooth decay and gum disease.
    • Oral infections and salivary gland infections may result.
    • Bad breath is associated with dry mouth.
    • A dry mouth can affect speech, swallowing and taste.
    • Difficulty with dentures can be a result of dry mouth.
    • Saliva is essential for the suction that dentures need to be firm and stable.
    • Dryness and a slight burning feeling in the mouth.
    • The corners of the mouth and the lips can become dry and cracked.

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4. What treatment is there for dry mouth?

  • The treatment of "dry mouth" relates to stimulating the production of saliva and treating the symptoms:
    • It is very important to stimulate the salivary glands by vigorous chewing.
    • Eat foods that require chewing such as fruit and vegetables.
    • Chewing sugarless gum also stimulates the flow of saliva.
    • Sialogogues are drugs that can be used to increase the flow of saliva.
    • Relief can also come with mouthwashes, lozenges, or toothpastes.
    • Sipping cold water or sucking ice can also bring relief.
  • Oral hygiene is important. Brush your natural and replacement teeth well.
  • Mouth infections and periodontitis that are caused by dry mouth can be treated with a fluoride or chlorohexadine mouthwash.
  • When the cause of the dry mouth is a medical condition, the correct treatment will be advised.
  • Ask your dentist how to maintain a comfortable mouth.

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5. Where does saliva come from?

  • Saliva is produced in the salivary glands.
    • The average production of saliva is 1.5 litres per day, or 45 litres per month.
      This might seem to be a lot of saliva, but remember it is being produced continuously for 24 hours of every day.
  • There are three pairs of salivary glands in the mouth:
    • The parotid salivary glands are in the cheeks, between the ear and nose.
    • The submandibular salivary glands are on the floor of the mouth, near to the lower molar teeth.
    • The sublingual salivary glands are under the tongue.

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6. What are the functions of saliva?

  • Saliva plays a vital role in several important functions:
    • Eating: Unless food is moistened by saliva it cannot be properly tasted or chewed.
    • Swallowing: Dry food is difficult to swallow. It would tear the lining of the throat. Liquid is needed to be able to swallow. Saliva performs that role.
    • Speech: Speaking dries the mouth. Despite the normal presence of saliva, speakers often need to sip water when they make long speeches. Normal speech would be impossible without saliva.
    • Digestion: Food that is not chewed and moistened by saliva is difficult for the stomach to process.
    • It plays an important role in the prevention of tooth decay.
    • It may be used to test for diseases such as cancer and HIV.

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7. How does saliva prevent tooth decay and gum disease?

  • Saliva prevents decay and gum disease in many ways:
    • The flow of saliva helps to wash away food debris.
    • It is alkaline, and so it helps to neutralise mouth acids and reduce decay.
    • It helps to protect the teeth from erosion caused by acids in the diet.
    • The saliva dilutes the strength of the acid.
    • Plaque growth and calculus formation are slowed or inhibited.
    • This reduces the risk of gum disease.
    • The calcium content of saliva can help to reverse the early stages of decay. This is called remineralisation.

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8. What influences the flow of saliva?

  • The flow of saliva is stimulated by the act of chewing.
    People who are too frail to chew properly are unable to produce enough saliva for a healthy mouth.
  • The smell, taste, sight, or even the thought of food stimulates salivary flow. Haven't we all salivated at the thought, sight, smell or taste of something delicious!

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